Staged complete revascularization in patients with acute myocardial infarction and multivessel coronary disease is superior to culprit PCI only at five-year follow-up. The outcomes of this retrospective analysis show the benefit of staged PCI, though it might be attenuated in diabetic patients. Outcomes are consistent with previously published randomized studies. Nevertheless, we should remain cautious...
Going beyond the culprit artery during angioplasty was associated with lower mortality, although this was a cohort study that should be confirmed through randomized trials. According to this new observational study, patients experiencing non-ST-segment elevation myocardial infarction with multivessel disease seem to benefit from complete revascularization during initial angioplasty. This study, published online before...
Recent studies in patients undergoing acute myocardial infarction showed that a complete revascularization strategy in an acute or subacute setting, whether it be guided through angiography (PRAMI, CvLPRIT) or fractional flow reserve (FFR) (PRIMULTI, COMPARE-ACUTE), improves the combined endpoint of major adverse cardiac events (MACE) when compared with treatment of the culprit artery only. Based...
Around half of all cases of ST-segment elevation acute myocardial infarction (STEMI) come alongside lesions in another vessel, for which the current strategy is complete revascularization in one or two steps. However, there are no large-scale studies analyzing patients who also present cardiogenic shock; we only have observational studies with inconclusive results influenced by several...
Several studies show that patients with multivessel lesions who undergo angioplasty with incomplete revascularization experience more events, including higher mortality, than a cohort of patients who have undergone complete revascularization. In most cases, the analysis was dichotomic (complete vs. incomplete revascularization), but more recent studies show that there may be a gradient, a continuum, in...
Courtesy of Dr. Carlos Fava. TAVR has proven to be beneficial for inoperable and high-risk patients, as well as for intermediate-risk patients. However, while many comorbidities have been analyzed, the presence, severity, and impact of coronary disease has not been well studied yet. This study analyzed 1270 patients who underwent TAVR. They presented >50% lesions in a major epicardial...
The aim of this study was to determine whether incomplete revascularization is associated to higher adverse events risk and acute myocardial infarction in patients undergoing non-cardiac surgery. Coronary artery disease patients or patients with prior PCI often have non cardiac surgery. These patients may have had all obstructions treated before surgery (complete revascularization) or...
This study presented at the American Heart Association Scientific Sessions 2016 and simultaneously published in the Journal of the American College of Cardiology, showed incomplete revascularization is associated with an increased risk of adverse cardiac events, particularly infarction, in patients that must later receive non-cardiac surgery. Patients with incomplete revascularization (defined as a ≥ 50% left...
Exhibitor: Ajay Kirtane Recorded by TV Med
Original Title: Effects of Ranolazine in Angina and Quality of Life after Percutaneous Coronary Intervention with Incomplete Revascularization Results from the Ranolazine for Incomplete Vessel Revascularization (RIVER-PCI) Trial. Reference: Karen P. Alexander et al. Circulation. 2016 Jan 5;133(1):39-47 Courtesy of Dr. Santiago Alonso Persistence or return of angina after PCI is relatively frequent, which is why...